Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinicopathological data of 1146 enucleated eyes obtained from 1146 patients (485 females and 661 males; mean age 57.4 (SD 21.6) years) between 1980 and 1990 were reviewed. The most common underlying diseases included trauma (37.4%), malignant tumours (19.6%), systemic diseases (diabetes, vascular diseases) (17.1%), surgical diseases (retinal detachment, glaucoma, cataract, corneal dystrophy) (14.1%), infection and inflammation (7%). The most frequent indications for enucleation were secondary angle closure glaucoma (34.9%), ocular malignant tumours (21.7%), atrophia or phthisis bulbi (18.7%), ocular infectious or inflammatory disease (14.7%), and recent trauma (enucleation was performed within the first month after trauma) (11.2%). Histopathologically, diagnoses included secondary angle closure (691 eyes or 60.3%), rubeosis iridis (550 or 48%), endothelialisation of the iridocorneal angle (198 or 17.3%), and retrocorneal membrane (143 or 12.5%). These data indicate that rubeosis iridis, often followed by irreversible secondary angle closure, represents the most common pathogenetic reason for enucleating eyes. Management procedures must be directed towards the prevention or consequent therapy of rubeosis iridis.
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PMID:Clinicopathological review of 1146 enucleations (1980-90). 819 9

93 eyes (93 patients) of complicated retinal detachment were treated with vitreo-retinal surgery. Among the series, 75 eyes were rhegmatogenous with PVR C3-D3 in 66 eyes (88.0%), while the remaining 18 eyes were traction induced. None of the cases had giant tears or complicating diabetes. On discharge from the hospital, the operation was effective in 62 cases (66.7%), in whom the retina was totally reattached or only a small amount of subretinal fluid remained. In a group of 40 eyes where the inert gas SF6 was used, the operation was effective in 30 cases (75.0%). 41 cases were followed up postoperatively for over 3 months, averaging 13.7 months, to find the operative results stable in 33 eyes (80.5%), with the visual acuity improved in 22 cases (66.7%), unchanged in 9 cases (27.3%), and decreased in 2 cases (6.0%). The operative procedures, the peeling of pre-retinal membrane, the effect of PVR severity on the operative results, and the promotion of operative efficacy by application of wide encircling buckle and inert gas tamponade were discussed.
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PMID:[Vitreo-retinal surgery for complicated retinal detachment]. 824 88

Ophthalmic surgery is one of the most valuable indications for ambulatory anaesthesia (AA). Respecting the usual recommendations for AA and the specificity of ophthalmic surgery, AA has very few problems. In USA it concerns about 90% of ophthalmic surgery. Most of the patients are very young or very old. Adults are often poly-medicamented: diabetes and arterial hypertension are the most frequent pathologies. A lot of multivisceral pathologies are responsible of ocular diseases and can complicate anaesthesia. It is necessary to diagnose them before anaesthesia. Maligna hyperthermia risk is increased during strabismus and ptosis surgery. Some ocular treatments have systemic repercussion and require to be stopped before anaesthesia. Most of ophthalmic surgery can be practiced under any types of local anaesthesia. In postoperative of strabismus and retinal detachment repair, pain, nausea, vomiting are frequently observed. Their prevention is not very well known. The atropine used for cardiac reflex treatment may be responsible of an acute urine retention or a disorientation in elderly patients and delays the home readiness. Paper and pencil tests after general anaesthesia are very difficult to do, because requesting a good vision. The postoperative complications are essentially surgical complications.
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PMID:[Characteristic problems posed to the anesthetist by ambulatory surgery in ophthalmology]. 840 83

Retinal complications of diabetes mellitus are chronic but late functional signs can lead to delayed diagnosis and treatments. Light coagulation (argon laser radiation) is recognized for its efficiency at the stage of "mature" retinopathy, converting the prognosis of a disease which was leading to blindness. Photocoagulation is not used in the early stages (early or strictly posterior pole diabetic retinopathy); partial regression or stabilization can be hoped with intensive medical treatment of diabetes. Treatment of diabetes could become the best preventive treatment. Light coagulation is used at stages when the disease is not reversible (non or preproliferative and proliferative). In tractional retinal detachment surgery remains active, always corresponding to too late treatments. Although pharmacology has progressed (inhibitors of platelet agregation and of non enzymatic glycation) medical therapy remains controversial.
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PMID:[Diabetic retinopathy]. 894 78

To minimize the risk of visual loss and to stop the progression of diabetic retinopathy argon laser treatment is the therapy of choice in proliferative diabetic retinopathy (PDR). The results after panretinal argon laser coagulation (ALC) were studied retrospectively considering visual outcome and frequencies of diabetic ocular complications. In all 95 patients were included in whom laser treatment had been performed due to clinically and angiographically diagnosed proliferative diabetic retinopathy at the Department of Ophthalmology between 1990 and 1994 with a follow-up of at least 1 year. The most frequent diabetic complications observed were vitreous haemorrhage in 9 (or 9.5%) and iris neovascularization in 10 cases (or 10.5%). Rare complications were neovascular glaucoma in 3 patients (or 3.2%) and tractional retinal detachment in 4 patients (or 4.2%). Nearly 70% of the patients maintained or improved visual acuity after laser treatment. The frequency of diabetic complications of PDR after ALC was significantly associated with older age, diabetes type II, longer duration of diabetes and elevated blood pressure.
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PMID:[Results of pan-retinal argon laser coagulation in proliferative diabetic retinopathy]. 908 26

The authors describe the rare complication of hypopyon uveitis following panretinal photocoagulation. A 55-year-old man with a history of diabetes mellitus and previous repair of a retinal detachment by scleral buckle and vitrectomy was referred to the authors after a hypopyon uveitis developed following supplemental panretinal photocoagulation. The patient was treated with frequent topical steroids in addition to periocular injection of steroids with resolution of the inflammation. Risk factors for anterior segment ischemia, such as a history of a scleral buckle, may predispose diabetic patients to the complication of hypopyon uveitis following panretinal photocoagulation.
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PMID:Hypopyon uveitis following panretinal photocoagulation. 918 55

The vitreous body plays an important role in the structure and in the function of the eye. Its bio-rheological properties contribute crucially to the mechanical resistance and optical transparency of ocular tissues. The composition and structure of the vitreous body change during aging and more rapidly in diabetes. These changes may have deleterious consequences such as functional disturbances and retinal detachment. The mechanical and optical properties of the vitreous are the result of its particular macromolecular architecture composed of a hyaluronan gel supported by a fine collagen meshwork, essentially of type II and IX. These are held together by proteoglycans and by fibronectin. All these macromolecules are susceptible to free radical damage produced by UV and visible light, by metabolic processes as well as the Maillard reaction. The mechanisms by which Maillard products and free radicals play a role in the physiological or accelerated aging of the vitreous are discussed in this review.
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PMID:[Aging of the vitreous body. Role of glycation and free radicals]. 929 81

Membrana limitans interna retinae (MLI) has been studied since 1871 and in structure and composition have been discussed since then. With the use of electron microscopes when studying the MLI a new terminology has been introduced, i.e. the vitreoretinal border region (VBR). In this survey, ther general concept of basement membranes has been applied to the VBR. The VBR consists of two major components. The inner: anchoring fibrils of the vitreous body and the outer: MLI. The MLI is further defined as composed of three structures: the fusing points of the anchoring vitreous fibrils, lamina densa and lamina lucida. Stress forces between the retina and the vitreous body are transmitted via this border region, and may cause severe clinical conditions such as retinal detachment. To investigate this border region morphologically, improvements in the conventional preparation technique for scanning electron microscopy (SEM) were found to be necessary in order to exhibit more details of the VBR. A new rapid procedure for desiccating frozen resin-cracked retinal tissue using hexamethyldisilazane was found to be appropriate. Sixteen pairs of normal eyes, 16 pairs of monkey eyes, 55 pairs of non-normal eyes from different animal species, enzyme digested monkey retinas and the retinas of two rat models with diabetes and hypertension respectively were investigated. In addition to SEM, the vitreoretinal border region was also investigated by means of light microscopy and transmission electron microscopy. The material was analyzed morphometrically. The human MLI increases markedly in thickness during the first months/years of life in the equatorial and macular regions. The thickness is stable from the second decade, and remains unchanged throughout subsequent decades. A regional difference in thickness of the MLI was found in all human adult eyes and in monkey eyes; it was thickest in the macular region. The length of vitreous fibrils close to the MLI also varied between the four regions in human eyes, the longest being in the ora serrata region, the second longest in the equatorial region, the next longest in the optic disc region and the shortest in the macular region. A morphological similarity in the appearance of the VBR was found in humans and monkeys. All other animals, except for cephalopods, showed a marked uniformity of the VBR. The enzyme-digested monkey retinas showed the fibrillar meshwork of the VBR to consist mainly of collagen fibers surrounded predominantly by hyaluronic acid. No firm correlation between thickness of the VBR and diabetes or hypertension could be demonstrated in the two animal models.
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PMID:Morphology of the vitreoretinal border region. 929 70

Several evidences suggest a retinal participation to the genesis of diabetic eye complications by means of an increased free radical production at this level. However, no direct proof exists that this happens in humans in vivo. Therefore, the concentrations of malondialdehyde (MDA), carbonyl and sulfhydryl (P-SH) proteins, and vitamin E have been assessed in the subretinal fluid (SF) of patients affected by retinal detachment. Diabetic (n = 19) and nondiabetic (n = 21 ) subjects with comparable age, degree of myopia, and duration of the retinal detachment were considered. A control group of n = 7 subjects was included. The SF was collected after drainage during surgery. The concentrations of total proteins, P-SH, and carbonyl proteins were determined with spectrophotometric methods; the levels of MDA and vitamin E were measured by HPLC. The protein concentration in SF did not differ among groups. A higher concentration of MDA (p < .01) and carbonyl proteins (p < .02) were found in diabetic compared to nondiabetic subjects. Diabetic patients also showed a lower content of P-SH (p < .002) and vitamin E (p < .001) compared to nondiabetic subjects. All these parameters were more markedly altered in patients affected by proliferative diabetic retinopathy and significantly differed between patients and control subjects. In conclusion, oxidative events are associated with retinal detachment in humans. This evidence strongly suggests that the retina is a source of free radical production under certain conditions, such as diabetes.
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PMID:Oxidative retinal products and ocular damages in diabetic patients. 968 Jan 84

We report a 39-year-old male patient with proliferative diabetic retinopathy associated with a mutation in the mitochondrial DNA and with his family. The patient was referred for fundus examination in 1993. He had been diagnosed as having diabetes mellitus 15 years before but his diabetic control was not good. He was thin and short and presented with bilateral proliferative diabetic retinopathy. When he received pan retinal photocoagulation, an exudative retinal detachment was found in his left eye, but it disappeared spontaneously. The patient's history included sensorineural deafness and autonomic nerve system disorder. Mitochondrial analysis obtained from blood showed mutation of adenine to guanine at mitochondrial DNA 3243. Generally speaking, mitochondrial disorders often include pigmentary degeneration. For this reason diabetic patients with mitochondrial disorders rarely suffer proliferative diabetic retinopathy. In this case, the retinitis pigmentosa was not so severe as to cause the proliferative change, so that it was probably derived from heteroplasmy.
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PMID:[A familial case of proliferative diabetic retinopathy associated with a mutation in the mitochondrial gene]. 985 18


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